To extend Angie's question a bit, I assume that too many don't understand
the difference between OCD and being obsessed by something, such as being
an avid collector, a workaholic or a musician (who practices all the
time). Is this perception of mine correct?

>>>How about (reaction to your OCD) within your intimate circle?<<<
(Angie)
You know, it's funny, Angie. With the benefit of hindsight, I now see
that my family (and those few others I shared with early on) were
probably far more ready than I was to talk about the whole thing early
on. I think I resorted to my "Dear family" letter out of embarrassment
and shame, really. For many years to follow, my OCD was the
proverbial elephant in the room. Again in retrospect, this was not a
healthy way for any of us to process things, and this is why I now
encourage those OCs I meet to have frank, open conversations with their
families about what they're going through--even if doing so means
putting everyone through the (temporary) discomfort of raw truth.

RE: OCD vs. "Normal" obsessions and compulsions
>>>how can we differentiate normal, temporary obsession with something
and full blown OCD? Is it when the obsession interfere's with one's
life and causes you to be unhappy? <<<
>>>Are there marginal cases that involve reasoning and language? I'm
thinking of people that insist upon precision regardless of the casual
nature of much of everyday discourse and the inherent vagueness of many
of our concepts.<<<
I suppose I'm the least qualified person to answer questions about
"normal" doubts and reactions to them. I lost my "normal" benchmarks
years ago. That said, though, I'm hearing frequently from people who
tell me they can relate to the core cycle of OCD, because they too have
taken basic actions to rid themselves of various doubts
(double-checking a door, for example). So what sets an OC apart? Two
things, really: first, the degree of distress caused by the obsessions
and failure to carry out the associated compulsions; and second, the
degree to which the whole cycle (as stated above) "interferes with
one's life."
I'm often asked about neatness issues: "I like my cans of soup to be
lined up with all the labels facing forward. Does that mean I have
OCD?"
"Not necessarily," I usually reply, and attempt to convey this through
an example from my own life. I like to have my closet VERY neatly
organized--shirts arranged on color-coded hangers by various types,
pants clustered by color and fabric, etc. I actually get great
pleasure when I have all the pieces neatly in their places. But,
here's the thing: I suffer no real "distress" whatsoever if my clothes
are not as I'd like them. In fact, more times than not, they're all
mixed up until I can find the time to rearrange them. I can't imagine
ever being late for work because I'm stuck in my closet rearranging
clothes. This, for me, is *not* one of my OCD patterns, like the
washing and checking drills that bring me little pleasure when I carry
them out, and great distress when I can't.
With that said, I have OC friends who are known as "orderers," and
they most definitely do suffer serious distress when their clothes, and
various other items, are not arranged in some very precise pattern.
They tell stories of their lives torn apart by their time spent putting
everything in order, much as I might describe all my lost time washing
and checking.
It's all more complicated than this, of course, but these distress and
interference standards are pretty good guideposts.

RE: OCD Portrayals
>>>Entirely by coincidence, the movie, As Good as it Gets, with Jack
Nicholson, was playing on our cable this weekend. Perhaps you've seen
the movie, do you think it was accurate in how it portrayed Melvins'
OCD? <<<
>>>what's your overall impression of OCD as portrayed in the media
(over and above the aforementioned Monk)? I've seen depictions on Law
and Order, and they've probably cropped up in comedies too. <<<
I loved "As Good as it Gets," and I think that movie, more than
anything else I can point to, gives me a starting point in
conversations about OCD.
ME: "The book is about my battles with obsessive-compulsive
disorder..."
OTHER GUY: "Obsessive... What?
ME: "Um, well, have you ever seen As Good as it Gets?"
OTHER GUY: "Yeah."
ME: "Remember Jack Nicolson's character and the--"
OTHER GUY: "Oh, yeah, yeah, OCD..."
One of the things I like about the movie is that, while it's funny as
all get out, it also hints at the great agony associated with the
disorder. Cleary, Melvin is not doing his thing to make himself happy,
but rather to avoid being miserable. One of the most poignant lines in
the move, for me, is Melvin telling Helen Hunt's character that she
makes him want to take his pills (almost always an inherent challenge
for OCs). That's powerful stuff, on so many levels!!
My only real sensitivity about Hollywood's depiction of OCD is not
that it finds so much humor in the disorder (there is much to be
found!) or even that it portrays most OCs as especially quirky (so many
of us are!), but rather that it often fails to convey the associated
agony and shame.
I once caught a "Scrubs" episode in which Michael J. Fox guest-starred
as a surgeon battling OCD. The show's a comedy, so predictably was
full of OCD humor. But in one scene, we got to see Fox's character
stuck at a sink, and the mounting frustration he was fighting as he
fought to break away from the basin. "Yeah, that's it," I remember
thinking. With one extra 15-second shot, the show took its audience
that extra step into life with OCD.

Jeff, does it ever get to you that others casually (and ignorantly)
equate their relatively "normal" rituals to your much deeper struggle?
In my struggles with an eating disorder, I find it nearly impossible
to stay serene in that situation. If I confide something about my
particular battle, and am met with "yeah, I really pigged out at a
party last night", or, "sure, I'd love to drop a few pounds", it's
hard to hear. The words imply an understanding that really isn't
there, and the tone minimizes the pain of a true compulsion. Add to
that the very human frustration at being unable to convey what I mean,
and I end up wanting to strangle either myself or the other guy.
In contrast, you sound very calm confronting those reactions. Are you?
If that's a learned reaction, how did it evolve?
And a follow-up question to an answer upstream ...

>>I think I resorted to my "Dear family" letter out of embarrassment
and shame, really. For many years to follow, my OCD was the proverbial
elephant in the room.
Who broke the ice first - you, or the various family members? In
retrospect, how might you have handled this differently? How might you
wish your close ones - individually or as a group - dealt with it more
productively? Was your hand forced in any case? Do you wish it had
been?

RE: OCD Ignorance
>>Jeff, does it ever get to you that others casually (and ignorantly)
equate their relatively "normal" rituals to your much deeper struggle?
<<<
Wow. I'd sure like to tell you this doesnt get to me, but, yeah, it
does. I was just having dinner with a dear friend of mine a few weeks
back, when another friend of ours wandered by and wound up joining our
conversation about the book. Before I knew it, this guy is going on
about how he likes to keep his house in immaculate condition and offers
up something like, "You're in good company; I'm a neat freak too."
After he took off, the first thing my friend said was, "That has got to
drive you nuts!!" I was impressed that she would understand that,
much as I'm impressed that you do, as well, Angie. I always thought it
was my own self-centeredness about these things that made me bristle.
Guess it's human nature to want our challenges to be understood, and
not minimized.
I will say this, though: I find myself getting a whole lot less worked
up (or feeling a need to explain things) now that my story is in
print. So much easier, really, just to smile and suggest that, since
we have so much in common, they really ought to pick up a copy of my
book. I get the last word...and a book sale to boot. (Yeah, okay,
maybe my inner-twit takes too much pleasure in that all; but, hey, they
started it. ;-)

RE: Family members
>>>Who broke the ice first - you, or the various family members? <<<
As I recall, it was I who broke the ice with virtually every family
member with whom I'd shared my "coming clean" letter. In their
collective defense, I had asked in that letter for some time to get
used to talking about things. In retrospect, I put them in an awkward
and unfair position, given that I ultimately found myself getting
somewhat bent out of shape by the very silence I'd asked for!
If there's one lesson I've drawn from the whole thing, it's this:
Respect a friend's request for "space," when they ask for it, but don't
assume that your follow-up would be unwelcome. I also pause now when
I catch myself thinking, I don't know what to say, so I won't say
anything. No; that's not the answer. Say something. It's that act of
saying something, not what's said, that's the real gift we have to
offer.

Let's switch for a moment from the content of your book to its tone.
It's immediately casual and intimate. And - I know I've used this word
already - but the term "bald" kept coming back to me as I read. The
honesty and detail of your obsessiveness stunned me more than once.
Taking your daughter to a dismal city roadway, trying to palm it off as
a fun outing, while you were in fact feeding your drive to check a
potential accident spot yet again - I squirmed. You were trying to
deceive her; you certainly didn't plan to share this with Sam.
The parallels to other addictions are inescapable. Addicts wheel and
deal to get what they need, while manipulating their families to hide
what's going on. I squirmed more than once, wanting to look away from
your pain and efforts to make it all work.
And woven throughout - jokes, puns, humor both bright and black -
you've put together a narrative that could well be a letter catching up
a good friend, someone you trust, someone you know it's okay to bare
this all to.
Can you talk about how you achieved that tone? How you arrived at the
tack you would take to engage the listener? How did the book change as
you wrote it, how did the first draft differ from the last?

Hooo BOY do I know what you mean about people saying "yeah, I'm a neat
freak too." It happens to me too (around another condition). I really
think it's about people wanting to connect, not minimize.
So how much of this turns out to be nature, and how much nurture? Did
you have a genetic predisposition to nervousness that got kicked into
high gear by your dad's perfectionism plus a cocktail of other
coincidences? Do you watch your kids for signs that they might have
OCD?
It is amazing to remember that it was such a short time ago that
people didn't have this alphabet-soup vocabulary for the many things
that can go wrong!
Slipped by Angie with a great, great question!

RE: OCD and Addiction
>>The parallels to other addictions are inescapable. Addicts wheel and
deal to get what they need, while manipulating their families to hide
what's going on.<<
I've never battled any kind of alcohol or drug addiction, but I've got
to believe the challenges are *very* similar. At my worst, I was a
crack addict (at least as I've seen them depicted in the movies). The
"junkie" in me would do virtually anything for my checking "fix" (keep
my two-year-old daughter out in the pouring rain, lie to coworkers and
friends, trade away my last shred of dignity, etc.). The sense of
relief I got from feeding my compulsion (getting that "fix") was
nothing short of a quick "high" for me, and every bit as ephemeral.
As I describe in the book, an AA-affiliated support group I stumbled
across proved to be a huge source of comfort and inspiration for me,
largely because I could so relate to the stories I heard, and the
lessons in letting go that I learned. When it comes right down to it,
OCs, alcoholics, and other addicts are all feeding the same destructive
cycles--each in search of immediate, albeit short-lived, comfort.

RE: Narrative tone and approach
>>you've put together a narrative that could well be a letter catching
up a good friend, someone you trust, someone you know it's okay to
bare this all to. Can you talk about how you achieved that tone? <<
I'm a longtime radio guy, trained to "write for the ear," which, for
me, has always meant imagining how my words would *sound* in
conversation. In fact, the best advice I ever got in broadcasting was
this: Imagine a single listener (a woman driving her kids to soccer, a
man shaving in front of his mirror, etc.) and talk directly to him or
her. Although I don't think I consciously set out to do this when
writing my narrative, I'm sure I did so by default, not knowing any
better, really.
One of the greatest risks I took with the narrative was deciding to
break its flow with "pauses" addressing the reader directly. Some
editors I shared the ms with early on felt this approach was too
disruptive, but I wanted to offer readers a break from the intensity of
my endless OCD cycles, and I wanted to remind them that I, too, could
understand their dismay! Right or wrong in a literary sense, I'm
awfully glad in retrospect that I stuck with these pauses.

RE: OCD -- Nature vs. Nurture
Ah, the great debate!
Actually, from my vantage point, the debate is quickly giving way to
consensus, and that consensus has "nature" trumping "nurture" pretty
soundly. Increasingly, researchers are isolating physiological
distinctions in the OC brain, and while I don't pretend to understand
much of this neurology, I've gotta say it's pretty dang fascinating.
Scientists, I've read, are also getting ever closer to isolating an
"OCD gene."
My view is that those of us who are OC came into this world pre-wired
that way. With that said, though, I'm also convinced that certain
childhood environments (notably, ones dominated by parental
perfectionism) are likely to trigger, or greatly complicate, the
disorder in those predisposed to develop it. It's for this reason that
I've attempted to convey the role of perfectionism in my own life.
Parents of kids showing any signs of OCD need to be especially
sensitive to this.
Re. my own kids, I'm afraid this is the one and only area of my
personal story that, for privacy reasons, I can't comment on. Speaking
"generically," I can tell you it's very common for OCD to run in
families, and I would strongly advise OC parents to watch for signs of
the disorder in their children.

Jeff, one thing I've been wondering about is whether when you try
something new (like, say, participating in an online author-reader
discussion forum) you find OCD behaviors waiting for you there. Or do
they take time to develop?

RE: OCD and Addiction
>>when you try something new [do] you find OCD behaviors waiting for
you there.<<
Yes and no, David. After so many years of dealing with my own
particular obsessions and compulsions, I've come to know them all too
well. Very seldom does something arise that I haven't already seen in
some form or another. My challenges these days tend to be pretty
predictable, and because of this, I almost always find myself thinking
through how they're likely to manifest themselves in any given
situation. Take this opportunity to chat with you all here, for
example. Before accepting your kind invitation, I went through my usual
drill of thinking through the likely OCD issues: the precision of my
answers, the potential to share information that could be misunderstood
(and therefore somehow harmful), etc. This screening process is, I
suppose, as illustrative as anything else I can think of, in terms of
OCD's pervasiveness.

That's a huge difference from your starting point! Early on, when your
symptoms flared up, you also tried to talk yourself out of obsessive
behavior, but your OCD won. Can you give us a glimpse of how that inner
dialogue is different now?

>>Early on, when your symptoms flared up, you also tried to talk
yourself out of obsessive behavior, but your OCD won. Can you give us a
glimpse of how that inner dialogue is different now? <<
Another especially astute question, Angie! So much of my battle with
OCD has centered on this very "inner dialogue" you reference. For so
many years, this dialogue was more akin to a monologue, really, with my
Voice of Doubt firing off a barrage of "what-if" questions more
quickly than I could answer them. Learning to cultivate my inner
"voice of reason" (for lack of a better term) has been key to my
recovery.
At the risk of oversimplifying a rather complex thought process, or
giving the impression that I hear actual voices in my head (I don't!),
allow me to attempt a quick example.
WORST OF TIMES: ( VoD = Voice of Doubt, VoR = Voice of Reason)
[tire hits bump in the road]
VoD: What was that?!!
VoR: Just a pothole
VoD: Are you sure?
VoR: Yeah, it---
VoD: How can you be sure?
VoR: Well, I felt the tire go--
VoD: Can you really be sure?
VoD: You'd better go back and check!
VoR: That's silly
VoD: Maybe.. but are you prepared to live with the uncertainty?
VoR: Well, uh, no... not really.....
TODAY (Most of the time!) ( VoD = Voice of Doubt, VoR = Voice of
Reason)
[tire hits bump in the road]
VoD: What was that?!!
VoR: Just a pothole
VoD: Are you sure?
VoR: No. I can't really be sure about anything, but I trust my
sensory input that tells me it was a pothole, and I trust my judgement,
despite your taunting... which I know is irrational... and the result
of misfiring neurons!
VoD: You really should go back and check!
VoR: No. That's a trap. It will only reinforce your power over me...
and I know from experience that no amount of checking will ever
provide that sense of certainty I'm looking for. I also know this
compulsion, too, is biologically based... nothing more than a mechanism
for dealing with my misfiring neurons.
VoD: But what if you're wrong? Are you prepared to live with the
uncertainty?
VoR: Yeah, that's another trap! The goal, I'm now learning, is not
to rid myself of that uncertainty, but rather to accept it, knowing i
CAN live with it. So there!!
Oversimplified? Definitely. But this, I'd venture to say, is the
gist of the shift in my inner dialogue.

This really helps with my much milder symptoms, which nevertheless do
include about 84 of this kind of inner dialogue I have per day. I'll treat
the next one like a skit, with the VoR having a much deeper, eloquent voice
(say James Earl Jones) than the VoD (Steve Buscemi).

heh, I agree about the "casting" ...
This has been an amazing two weeks, and you've covered so much ground, Jeff.
Thank you so much for sharing so much time with us, and for being so open
about your journey with OCD. It's been fascinating!
Though our virtual spotlight has turned to a new guest, this topic will
remain open for further conversation indefinitely. So if you're able to
stick around longer, Angie and Jeff, you're more than welcome to continue.
If you have things that are calling you away, then I'll simply say that I'm
glad you've joined us, and wish you all the best.

Wow, I've had one-hour interviews that seemed longer than this. I
can't believe it's been two weeks. Jeff, thanks for a fascinating book.
And to all the Wellbeings who contributed some valuable questions.
One follow-up, and one question for the road:
I don't have your book at hand just now, but I seem to recall your
mentioning something about externalizing the disorder - much has been
mentioned here. (In fact, there's a book out on eating disorders called
"Life Without Ed". "Ed" is the name the author gave her Eating
Disorder - get it? - which she then treated as an external force.) Has
this externalizing been helpful to other OCDs you've talked to?
And: what's the prognosis? Again underlining that you don't put
yourself out there as an expert, but what does your reading and
research tell you about what to expect as you get older? Changes in
meds needs, diminishing of symptoms - any idea?

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